| NPI | 1972518553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: MO 2011020280) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2011020280) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: MO 2011020280) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2022-01-12 |