| NPI | 1245467547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 34.011451) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0102203171) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2023-06-13 |