| NPI | 1851963813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V1052) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT224220) |
| Enumeration Date | 2021-07-10 |
| Last Update Date | 2024-06-20 |