| NPI | 1649717687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G078308) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.077129) |
| Enumeration Date | 2017-01-29 |
| Last Update Date | 2017-01-29 |