| NPI | 1609294248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101266536) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 149187) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2023-03-07 |