| NPI | 1104203561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-46671) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-10058) |
| 208000000X Pediatrics (Licence: MO 2019021224) | |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2022-08-31 |