| NPI | 1538201033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 2885) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA 05003781L) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2007-07-08 |