| NPI | 1235134859 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AZ 15087) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 15087) | 
| Enumeration Date | 2005-06-20 | 
| Last Update Date | 2025-09-11 |