| NPI | 1902107915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: OH 57.017415) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.120514) |
| Enumeration Date | 2010-11-07 |
| Last Update Date | 2013-05-10 |