| NPI | 1457367427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35075171) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301087628) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2008-10-24 |