| NPI | 1215163886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A114306) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 128609) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2021-12-06 |