| NPI | 1649697954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 55847) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 270030) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2018-11-08 |