| NPI | 1023441623 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A165938)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD211587)  | 
| Enumeration Date | 2013-08-19 | 
| Last Update Date | 2022-06-29 |