| NPI | 1871807990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35-121642) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT197716) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2013-07-15 |