| NPI | 1922535012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 55451) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2020-03126) |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2022-08-11 |