| NPI | 1659908366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 99879) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 260720) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2024-05-21 |