| NPI | 1053774604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0102206778) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34.013673) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2022-08-03 |