| NPI | 1134516362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 277548) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 63240) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2020-03-31 |