| NPI | 1366805319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A162381) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10498629-1205) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2020-02-02 |