| NPI | 1780665802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35088898) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 75909) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2007-07-08 |