| NPI | 1629272901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 43728) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35096112) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2014-12-02 |