| NPI | 1104486638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2023001532) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2019021234) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2023-05-17 |