| NPI | 1588749634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2015-01338) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN7900) |
| 208000000X Pediatrics (Licence: CT 046401) | |
| 208000000X Pediatrics (Licence: FL ME98701) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-10-28 |