| NPI | 1821431057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34012211) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 3879) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2024-04-11 |