| NPI | 1629773288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A24933) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GU TLL-2026-004) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2026-08-05 |