| NPI | 1154895381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 72177) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML61060420) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2024-12-02 |