| NPI | 1043212483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME130676) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35084597) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2022-07-11 |