| NPI | 1205285590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A162815) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT210609) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2019-07-22 |