| NPI | 1477973303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34012464) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 34.012464) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2018-07-06 |