| NPI | 1508846783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35092246) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2002014445) |
| Enumeration Date | 2006-01-22 |
| Last Update Date | 2011-09-06 |