| NPI | 1083059711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 48854) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY R3333) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2018-10-04 |