| NPI | 1568505071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME99801) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 40651) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2021-03-24 |