| NPI | 1659868560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61140296) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 11405455-1205) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2021-08-08 |