| NPI | 1619645710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 022494) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 022494) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2025-10-28 |