| NPI | 1619266160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 49497) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TN 49497) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2024-01-24 |