| NPI | 1104454461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2020017318) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-10396) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-06-23 |