| NPI | 1891179404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 55519) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101273988) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2025-12-24 |