| NPI | 1366675589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MT 18628) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R71717) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2019-09-13 |