| NPI | 1447518592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS14518) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 279339-1) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2021-06-17 |