| NPI | 1790726800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35070531S) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35070531) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2012-10-30 |