| NPI | 1306404611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MT217498) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2022-02312) |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2022-09-09 |