| NPI | 1871053942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1014111) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 61288086) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2023-05-02 |