| NPI | 1407433147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1019624) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A202379) |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2026-09-17 |