| NPI | 1497060263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 58.007764) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 902) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2018-03-17 |