| NPI | 1689052557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ R75024) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 55554) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2018-07-23 |