| NPI | 1639596513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MA 1016107) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 1016107) |
| 208000000X Pediatrics (Licence: KY 04085) | |
| 208000000X Pediatrics (Licence: OH 58.005635) | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2023-07-12 |