| NPI | 1205483377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 22252) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 34143R) |
| 208D00000X General Practice (Licence: PR 22252) | |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2022-11-19 |