| NPI | 1588769095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35030913) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OH 35030913) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-11-13 |