| NPI | 1700358686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 82562) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL82562) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2024-03-06 |