| NPI | 1053610311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 55433) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 120720) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2019-02-01 |