| NPI | 1356310486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 36.12214) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.061059) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2011-11-29 |