| NPI | 1053573311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D76726) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35096575) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2013-11-15 |