NPI | 1215315890 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD198902) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD61080964) |
208000000X Pediatrics (Licence: CT 61680) | |
Enumeration Date | 2015-05-14 |
Last Update Date | 2022-11-30 |