| NPI | 1639110950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 02151) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34003972) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2016-01-07 |