| NPI | 1841711769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 21723) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101023195) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2023-09-12 |