| NPI | 1912950361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101281679) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35073477) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-04-17 |