| NPI | 1063956902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 57151) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 43637-20) |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2016-12-12 |