| NPI | 1750630307 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: NH 20094) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 278860) | 
| Enumeration Date | 2012-08-29 | 
| Last Update Date | 2024-02-13 |