| NPI | 1871546796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2019-02645) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35079822) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-04-15 |