| NPI | 1427233634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 35097685) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: WV 24470) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2015-11-02 |