| NPI | 1811204746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME167458) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 70069) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2025-08-13 |