| NPI | 1366905127 |
|---|---|
| Former Name | EMILY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OK 40280) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 11912748-1205) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2023-02-16 |