| NPI | 1205096260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 575) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34.010876) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2019-02-19 |