| NPI | 1205497807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301506344) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4351044828) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2022-09-22 |