| NPI | 1750617379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 57453) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.016589) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2012-09-06 |