| NPI | 1972695559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35054557N) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 54557) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2018-06-16 |