| NPI | 1083811830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35122961) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 42418) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2014-03-11 |