| NPI | 1629056015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 38555) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35083903B) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: KY 38555) | |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: OH 35083903B) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2016-03-10 |