| NPI | 1922281757 |
|---|---|
| Former Name | MARY BOOTH VADEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.093420) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2007-01947) |
| 208000000X Pediatrics (Licence: OH 35.09320) | |
| Enumeration Date | 2007-12-16 |
| Last Update Date | 2021-10-05 |