| NPI | 1114260973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 61166) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A143307) |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2022-04-15 |