| NPI | 1790313120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301518304) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A190254) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-07-17 |