| NPI | 1063773752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD182140) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 29315) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2019-09-19 |