| NPI | 1184936536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203593) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58.004303) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2014-10-27 |