| NPI | 1073763306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.091443) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: FL ME 101603) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2019-08-23 |