| NPI | 1679851802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301106256) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35123470) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2024-12-13 |