| NPI | 1174507255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 51287) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 41453) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2022-03-22 |