| NPI | 1902290448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KY 54522) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 122017) |
| 208000000X Pediatrics (Licence: KY 54522) | |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: CA A154580) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2024-09-05 |