| NPI | 1255786026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 54569) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 36313) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2021-08-27 |