| NPI | 1366858672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS14786) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL UO3905) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2020-09-01 |