| NPI | 1053756163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 35128436) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35128436) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2021-03-25 |