| NPI | 1558749986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 162256) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 61075) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2022-02-11 |