| NPI | 1043289994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 47497) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.120003) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-05-07 |