| NPI | 1629417563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5101020284) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34013583) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2023-05-22 |