| NPI | 1104098177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2008-01705) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.009201) |
| Enumeration Date | 2008-03-29 |
| Last Update Date | 2016-10-12 |