| NPI | 1790905867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 3262) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0110001977) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2019-08-14 |