| NPI | 1801367602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD 08452) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD 08452) |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2018-12-06 |