| NPI | 1568753903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AR E-8792) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 305201) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2020-01-22 |