| NPI | 1972508448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 036690) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35036690) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2011-12-29 |