| NPI | 1508599655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2026037545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2026037545) |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2026-08-13 |