| NPI | 1912438953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR 198701) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 60756769) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-05-26 |