| NPI | 1790982361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 064662) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 29977) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2019-03-06 |