| NPI | 1063077204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2023009184) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.249600) |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2023-03-28 |