| NPI | 1295170827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: MI 4301502656) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301502656) |
| 2080H0002X (Licence: TX BP10067414) | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2020-08-11 |