| NPI | 1528488707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35130703) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 154494) |
| Enumeration Date | 2014-04-26 |
| Last Update Date | 2019-07-02 |