| NPI | 1275538126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 12743) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35077148) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2012-01-26 |