| NPI | 1518180397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ PG Permit # 76687) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: UT 7586186-1205) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2021-10-21 |