| NPI | 1811029036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101243895) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-089017) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-07-11 |