| NPI | 1053340810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301110891) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35061933B) |
| 208000000X Pediatrics (Licence: OH 35061933B) | |
| 208000000X Pediatrics (Licence: MI 4301110891) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2021-12-22 |