| NPI | 1790756112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35130077) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 12429) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2017-01-12 |