| NPI | 1528451929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 34.013182) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH AP2282058A36) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 34.013182) | |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2020-12-15 |