| NPI | 1417334111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A146710) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MT 94805) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2021-04-12 |