| NPI | 1376658492 |
|---|---|
| Doing Business As | |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 44337) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-041412) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2023-10-04 |