| NPI | 1619230745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 262010) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT201213) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2018-04-26 |