| NPI | 1033640453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V2701) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA10927500) |
| 208000000X Pediatrics (Licence: KY 55439) | |
| 208000000X Pediatrics (Licence: WI 85113-20) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2025-01-01 |