| NPI | 1457331555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KY 24703) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 24703) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2025-06-11 |