| NPI | 1689093189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101271842) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301114285) |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2021-08-25 |