| NPI | 1407112170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: MI 4301509345) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301509345) |
| Enumeration Date | 2012-04-07 |
| Last Update Date | 2023-08-03 |