| NPI | 1952718231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01082450A) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: OH 72173) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2023-06-16 |