| NPI | 1376706812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME119957) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-097067) |
| Enumeration Date | 2008-07-04 |
| Last Update Date | 2024-02-01 |