| NPI | 1821656190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 70169) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT217806) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2024-08-08 |