| NPI | 1659865459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD049286) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP04437) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2021-06-25 |