| NPI | 1306827530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 3746) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34005810P) |
| Enumeration Date | 2005-11-05 |
| Last Update Date | 2012-12-26 |