| NPI | 1083758056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD21918) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101055487) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2023-06-08 |