| NPI | 1760410583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD062711L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35 077386) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2007-07-08 |