| NPI | 1669979704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T9796) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A174530) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2022-09-26 |