| NPI | 1255695631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MS 831-L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0055507) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2021-03-08 |