| NPI | 1790710168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: TN MD46831) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NC 2006-01529) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-02-05 |