| NPI | 1407169717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 248883) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 12857) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2022-07-21 |