| NPI | 1649557919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A128040) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.020005) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2017-04-03 |