| NPI | 1902287972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.146326) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301107552) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2022-11-21 |