| NPI | 1629573621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A173731) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2022-03339) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2023-03-23 |