| NPI | 1952637530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2026-00436) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.094470) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2026-06-16 |