| NPI | 1104147669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 34011467) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NC 2012-01741) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2014-09-16 |