| NPI | 1760745087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 57172) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT201281) |
| 208000000X Pediatrics (Licence: PA MD454595) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2020-03-20 |