| NPI | 1790045151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 90685) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM MD2015-0779) |
| Enumeration Date | 2012-05-19 |
| Last Update Date | 2021-11-30 |