| NPI | 1497734677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD041862E) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-06-0030) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2011-07-21 |