| NPI | 1649259615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A100849) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101231260) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2021-12-13 |