| NPI | 1669553749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 35193) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD0000035243) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2024-07-19 |