| NPI | 1720244395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA 54787) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 54078) |
| 208000000X Pediatrics (Licence: PA MT193350) | |
| 208000000X Pediatrics (Licence: WI 60657-20) | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2025-07-07 |