| NPI | 1558604140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: OH 35.136587) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 76785) |
| 208000000X Pediatrics (Licence: MA 269600) | |
| 208000000X Pediatrics (Licence: OH 35.136587) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2023-04-10 |