| NPI | 1215374244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2016027887) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0439314) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2018-03-17 |