| NPI | 1255334462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35071655) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 41511) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2011-03-31 |