| NPI | 1013400217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 73748) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 275750) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2023-07-15 |