| NPI | 1649233065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35076243W) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 26619) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2007-12-05 |