| NPI | 1265963664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2017018249) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-09380) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2018-06-13 |