| NPI | 1659931129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101275665) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.074991) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2022-11-17 |