| NPI | 1215340187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0086382) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 50442) |
| Enumeration Date | 2014-06-08 |
| Last Update Date | 2020-11-20 |