| NPI | 1790758167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101241865) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 22229) |
| 208000000X Pediatrics (Licence: FL ME135318) | |
| 208000000X Pediatrics (Licence: PA MD427557) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2023-09-20 |