| NPI | 1396037289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 56064) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MT 42244) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2025-11-03 |