| NPI | 1649684069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KY 53966) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL37099) |
| 208000000X Pediatrics (Licence: KY 53966) | |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2020-06-19 |