| NPI | 1265845770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301104680) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 67156-20) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2020-02-12 |