| NPI | 1902847742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.075839) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-07-5839-P) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2021-03-30 |