| NPI | 1649505314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME113507) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.016096) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2016-07-14 |