| NPI | 1346775392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 314375) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60975728) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2022-07-26 |