| NPI | 1952340374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME82356) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35077156G) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2007-09-20 |