| NPI | 1871978999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 51515) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY R3835) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2018-08-10 |