| NPI | 1386936920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 264903) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 16672) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2021-03-19 |