| NPI | 1689676603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: OH 35078582) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35078582) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2022-02-15 |