| NPI | 1235620741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME158602) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX T0579) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2023-12-19 |