| NPI | 1275030942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 33849) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: NE 33849) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2024-08-06 |