| NPI | 1114135126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 090836) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME96117) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2008-08-20 |