| NPI | 1659941672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD.MD.61616273) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT224503) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2024-11-15 |