| NPI | 1104246768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A140401) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 40183) |
| 208000000X Pediatrics (Licence: PA MD471282) | |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2024-10-18 |