| NPI | 1528454196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 61167) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 264502) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2023-01-26 |