| NPI | 1710319116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 64367) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 266531) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2022-09-22 |