| NPI | 1013160779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60670393) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57-015030) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2021-06-29 |