| NPI | 1649605312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C179418) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 010257016) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2023-09-26 |