| NPI | 1366679607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 55732) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 55732) |
| 207Q00000X Family Medicine (Licence: OH 35.127011) | |
| Enumeration Date | 2009-06-13 |
| Last Update Date | 2019-02-04 |