| NPI | 1992151864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2019-00390) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH SS944301) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2022-02-10 |