| NPI | 1295777159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34006723) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34-00-6723-S) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2008-06-19 |