| NPI | 1922393842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-00325) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.123708) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2021-03-01 |