| NPI | 1790281822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX U1008) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 58.030186) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2024-11-14 |