| NPI | 1528405875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 04014) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY TP208) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2022-05-18 |