| NPI | 1700090735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.098461) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 098461) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2012-01-16 |