| NPI | 1407301690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A159695) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 341194) |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2026-03-13 |