| NPI | 1174521298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.068552) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 32418) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2015-08-11 |