| NPI | 1124510052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 325897) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL52544) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2021-08-10 |