| NPI | 1104115872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CT 53294) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N8655) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2018-11-28 |