| NPI | 1477728186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35096781) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 44442) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2012-02-15 |