| NPI | 1235557554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NH 18749) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2017-01349) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2019-01-08 |