| NPI | 1801246053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61373219) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2019014014) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2023-08-30 |