| NPI | 1740275866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 041814) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 209754) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2022-01-04 |