| NPI | 1578619086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 79511) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 036062) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2021-12-21 |