| NPI | 1861798084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 50.003218) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 50.003218) |
| 363AS0400X Physician Assistant, Surgical (Licence: OH 50.003218) | |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2023-01-04 |