| NPI | 1730612409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 53995) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.137152) |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2025-10-31 |