| NPI | 1972720530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 256231) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34.009243) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2019-11-19 |