| NPI | 1255822300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 4802) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34.016474) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2023-05-17 |