| NPI | 1073753141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34010656) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS015971) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2017-10-25 |