| NPI | 1649857921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2024-01172) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL 0536) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-10-31 |