| NPI | 1366972630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA OS020522) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0116030778) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2024-06-12 |