| NPI | 1356723308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SD 11023) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 7577) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2022-04-15 |