| NPI | 1639361710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35-121622) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 063135) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2014-04-28 |