NPI | 1386938173 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: GA 79145) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 260467) |
208000000X Pediatrics (Licence: GA 79145) | |
Enumeration Date | 2011-06-09 |
Last Update Date | 2021-01-29 |