| NPI | 1053847772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 63219) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 304857-01) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2021-12-06 |