| NPI | 1679206023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2025026604) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT225986) |
| Enumeration Date | 2022-07-04 |
| Last Update Date | 2025-07-29 |