| NPI | 1588012546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 59288) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL39510) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2022-03-14 |