| NPI | 1760913628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 75475-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2020014574) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2021-10-12 |