| NPI | 1104809508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL AL4556) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 4556) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2022-04-05 |