| NPI | 1659613727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 56625) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01081936A) |
| 208000000X Pediatrics (Licence: OH 35.125979) | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2026-01-13 |