| NPI | 1174780902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 244987) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VT 042.0012700) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2021-02-12 |