| NPI | 1619327806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD477973) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT212078) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2022-08-24 |