| NPI | 1063862886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A161670) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT210449) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2024-09-17 |