| NPI | 1942279153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35064363) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 44494) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2016-04-05 |