| NPI | 1336258920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: KY 40331) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 40331) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2024-01-05 |