| NPI | 1396746285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35048551) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: OH 35048551) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2013-12-02 |