| NPI | 1891114138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 157132) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 289577) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-05-27 |