| NPI | 1811147911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301091776) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.129145) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2016-09-19 |