| NPI | 1760862072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 263468) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 24681) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2024-01-10 |