| NPI | 1710388954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 53134) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 276798-1) |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2016-11-09 |