| NPI | 1679757330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D71196) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35090542) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2018-08-12 |