| NPI | 1073566014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 9500744) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 95-00744) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: NC 95-00744) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2024-09-09 |