| NPI | 1043979834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 290116) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD461271) |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2021-12-17 |