| NPI | 1316741788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2026025932) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-12871) |
| Enumeration Date | 2025-04-03 |
| Last Update Date | 2026-06-26 |