| NPI | 1629024997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SD 4890) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-5860) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-05-27 |