| NPI | 1205286036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 39730) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL39730) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2019-07-01 |