| NPI | 1649685728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD483794) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 6886) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2024-04-26 |