| NPI | 1124384391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 67569) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MT 41368) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2022-07-21 |