| NPI | 1063771319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C175546) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 74858) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2022-04-19 |