| NPI | 1407587785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 9392) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 37040) |
| Enumeration Date | 2022-06-18 |
| Last Update Date | 2025-08-11 |