| NPI | 1285660274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 03329) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34007335S) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2019-10-23 |