| NPI | 1649665423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 52011) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 209638) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2018-07-02 |