| NPI | 1811332158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WV 3455) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY R3400) |
| 208000000X Pediatrics (Licence: SC 40744) | |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2022-04-18 |