| NPI | 1730169533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 12600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.131675) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2019-01-18 |