| NPI | 1265674634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.123501) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 55321) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2015-02-17 |