| NPI | 1316923824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD434643) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35079907R) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35079907R) | |
| 207Q00000X Family Medicine (Licence: MI 4301073222) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301073222) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2009-07-20 |