| NPI | 1124107149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A93438) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CA A93438) |
| 174400000X Specialist (Licence: CA A93438) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2022-06-22 |