| NPI | 1912046244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 062861) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 267418) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2019-07-31 |