| NPI | 1952747396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.132878) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME134997) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: MD D0082710) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2021-10-11 |