| NPI | 1447686985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A166767) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 60208) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2020-08-17 |