| NPI | 1902921208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A108001) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.011419) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2014-06-19 |