| NPI | 1669024592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 22458) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 15447) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2022-01-11 |