| NPI | 1760867352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NM md2018-0708) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA PGY.203046) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2018-08-22 |