| NPI | 1629575634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V0780) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.142170) |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2024-05-16 |