| NPI | 1326346941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35123616) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11015852A) |
| Enumeration Date | 2011-03-06 |
| Last Update Date | 2019-06-05 |