| NPI | 1568533677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34-010808) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 11288) |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2014-01-29 |