| NPI | 1083830418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101247522) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57011788) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2010-11-16 |