| NPI | 1013086693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00048508) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35087520) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2021-03-01 |