| NPI | 1639638919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS18704) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL trainee) |
| Enumeration Date | 2019-03-17 |
| Last Update Date | 2022-08-30 |