| NPI | 1811229495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35072026A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01040050A) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2017-02-02 |