NPI | 1376074435 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: OH 34014437) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34.014437) |
Enumeration Date | 2017-03-21 |
Last Update Date | 2023-06-20 |