| NPI | 1598116998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 34014526) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 7723) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2023-05-16 |