| NPI | 1720012214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: OH 35070008) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35070008) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2010-04-28 |