| NPI | 1487404505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 94-12005) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2024020480) |
| Enumeration Date | 2024-03-22 |
| Last Update Date | 2024-08-27 |