| NPI | 1235589136 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD194986)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-10589)  | 
| Enumeration Date | 2016-06-21 | 
| Last Update Date | 2019-10-22 |