| NPI | 1639570286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 312379) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 19906) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2019-10-23 |