| NPI | 1972915742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 35.042152) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.042152) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2018-01-29 |