| NPI | 1649790130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.139635) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301113351) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2020-09-24 |