| NPI | 1124768049 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC LL87547)  | 
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NC 2025-01308)  | 
| Enumeration Date | 2022-03-30 | 
| Last Update Date | 2025-05-08 |