| NPI | 1053521047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35092471) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 101245305) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2018-03-21 |