| NPI | 1790427490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A209051) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT228833) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2026-08-07 |