| NPI | 1588655146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0040849) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35089965) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2021-06-21 |