| NPI | 1790965309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A116724) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 6599698-1205) |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2022-01-14 |