| NPI | 1639531932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 82520) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 1639531932) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2026-07-21 |