| NPI | 1154642130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0062959) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 69456) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2019-12-27 |