| NPI | 1871614602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.089177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 39311) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 35-089177) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2014-08-22 |