| NPI | 1609288547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 270620) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP03044) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2018-05-21 |