| NPI | 1962758169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 77945) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301101079) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2020-05-18 |