| NPI | 1043217839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.044589) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35044589L) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2011-10-06 |