| NPI | 1508387861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 41065) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL41065) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2021-06-30 |