| NPI | 1912572447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1020837) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT222574) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2025-06-10 |