| NPI | 1639312424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35123758) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL me 112972) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2018-06-28 |