| NPI | 1629059720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: OH 35086099) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35086099) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2022-02-18 |