| NPI | 1265495055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35067192A) |
| Additional Taxonomies | 208VP0000X (Licence: OH 35067192A) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2007-12-05 |