| NPI | 1093970758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35080335) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 25762) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2008-07-22 |