| NPI | 1518957265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2008011538) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34007396) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2011-07-27 |