| NPI | 1023336559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60672238) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-122806) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2019-09-12 |