| NPI | 1174855225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD 60207042) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 255769) |
| Enumeration Date | 2010-01-31 |
| Last Update Date | 2022-12-13 |