| NPI | 1215317243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 278290) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD464196) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2019-06-28 |