| NPI | 1447543970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.011210) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58004527) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2015-06-08 |