| NPI | 1245850650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX W5524) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.255040) |
| Enumeration Date | 2020-04-26 |
| Last Update Date | 2026-04-20 |