| NPI | 1912292814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 139024) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 27899) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2022-07-21 |