| NPI | 1700307626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 34014564) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101023609) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-03-11 |