| NPI | 1487185773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 284158) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT214072) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2020-10-14 |