| NPI | 1932767761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.015665) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151013777) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2022-06-21 |