| NPI | 1598966319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.093302) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 11304225480578.23) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2010-07-31 |