| NPI | 1306053970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35091526) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301084545) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2018-06-28 |