| NPI | 1114259900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME113655) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.016951) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2019-04-26 |