| NPI | 1942339874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.083468) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301073258) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2012-07-30 |