| NPI | 1871121871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 59132) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101279129) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2025-08-21 |