| NPI | 1114018454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35-123631) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C10008017) |
| 207Q00000X Family Medicine (Licence: NY 247240-1) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2015-01-26 |