| NPI | 1053562561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY TP837) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME110995) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2026-02-26 |