| NPI | 1053387019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 36669) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34004333W) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2014-11-25 |