| NPI | 1053637389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 054925) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CT 054925) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2022-09-23 |