| NPI | 1639165236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35089912) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 185059-1) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2009-04-08 |