| NPI | 1417179987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC LL28876) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.093716) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2012-06-05 |