| NPI | 1811042559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35058714) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 30205) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |