| NPI | 1508023110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.099163) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 204630) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2013-05-06 |