| NPI | 1033109095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NH 19572) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 159758) |
| 208000000X Pediatrics (Licence: WI 64573) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2023-09-06 |