| NPI | 1568466332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.098696) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 10378R) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2015-02-11 |