| NPI | 1245565944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.010558) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 34-010558) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2021-01-21 |