| NPI | 1558658997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 66662) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD31142) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2019-04-09 |