| NPI | 1912967027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 39520) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35051845) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2019-07-02 |