| NPI | 1902211816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-42128) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 49400) |
| 208000000X Pediatrics (Licence: MO 2019013399) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2022-01-31 |