| NPI | 1639121064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301112450) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.077201) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-03-17 |