| NPI | 1376830372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 277302) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 10039704) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2022-09-19 |