| NPI | 1346861374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1022737) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R3369) |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2025-12-08 |