| NPI | 1912137738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 33271) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 52715) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2020-09-09 |