| NPI | 1417394545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 270110) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP02806) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2022-07-21 |