| NPI | 1275633786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS17771) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34006079) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2021-05-17 |