| NPI | 1497288799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: FL ME168278) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: GA 103830) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2025-05-29 |