| NPI | 1629624648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 21519) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21519) |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2023-09-14 |