| NPI | 1922703321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.155668) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL89914) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2026-06-18 |