| NPI | 1639819857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC LL87618) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 6216) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-07-08 |