| NPI | 1942252812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.053774) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 35053774) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2014-02-03 |