| NPI | 1417497280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS15972) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL UO4874) |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2019-04-29 |