| NPI | 1306164694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 24133) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 14737) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2025-05-13 |