| NPI | 1225650369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1014868) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP04858) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2026-01-16 |