| NPI | 1568809515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NH 19879) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 9722545-1205) |
| 208000000X Pediatrics (Licence: RI LP02908) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2019-10-31 |