| NPI | 1700112612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2012-00678) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 34525) |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2023-06-21 |