| NPI | 1396123790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NH 18779) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP03443) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2019-01-25 |