| NPI | 1578504379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 220519) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101044383) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2023-01-13 |