| NPI | 1346653789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 54430) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R74365) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2021-09-14 |