| NPI | 1932337649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ R71616) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.128399) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2020-05-22 |