| NPI | 1518221464 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 87472) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 34745) | 
| 208000000X Pediatrics (Licence: GA 5512) | |
| Enumeration Date | 2012-06-26 | 
| Last Update Date | 2021-02-19 |