| NPI | 1912296096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NV 19630) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 53548) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2023-01-16 |