| NPI | 1679204903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 103346) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN35628) |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2025-07-18 |