NPI | 1992926810 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: OH 35.092913) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.092913) |
208000000X Pediatrics (Licence: OH 57.011600) | |
Enumeration Date | 2007-05-01 |
Last Update Date | 2023-11-03 |