| NPI | 1861699324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 8133411-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 54878-020) |
| 208000000X Pediatrics (Licence: MO 2007013531) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2021-08-02 |