| NPI | 1003259250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301114213) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 56541) |
| 208000000X Pediatrics (Licence: MI 4301114213) | |
| 208000000X Pediatrics (Licence: OH 35128153) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2018-08-14 |