| NPI | 1306961164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 065111) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 92190) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2010-10-22 |