| NPI | 1235132275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35045807) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301061029) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2017-02-10 |