| NPI | 1629052709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35120656) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200101226) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2013-02-01 |