| NPI | 1902833320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 180860) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35085419) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2022-08-08 |