| NPI | 1134412984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA OS016917) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT014215) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2021-12-02 |