| NPI | 1548790017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2020-00803) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP04104) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2020-12-09 |