| NPI | 1255332219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 1240) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34006616W) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2007-07-08 |