| NPI | 1902882095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35065511) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35065511A) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2011-08-02 |