| NPI | 1811045198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.094616) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 237301) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2013-11-13 |