| NPI | 1861856239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.148447) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2018-00206) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2023-11-16 |