| NPI | 1770748626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 51545) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 53932) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2021-06-23 |