| NPI | 1124281654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 122540) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 259937) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2014-07-02 |