| NPI | 1679913396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 34.012499) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101020757) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2020-11-24 |