| NPI | 1922417070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.128755) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.023993) |
| Enumeration Date | 2014-08-02 |
| Last Update Date | 2020-11-04 |