| NPI | 1063918753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2018022819) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-09687) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2020-01-31 |