| NPI | 1073992723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A154504) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 60725) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2018-07-11 |