| NPI | 1306802616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 355084078) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 39149) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2008-08-28 |