| NPI | 1568691954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS015887) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34010489) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2014-12-05 |