| NPI | 1881753713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M5716) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-082568) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2023-08-15 |