| NPI | 1407301690 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 341194) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A159695) | 
| Enumeration Date | 2016-08-17 | 
| Last Update Date | 2024-08-01 |