| NPI | 1699798249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301068721) |
| Additional Taxonomies | 2080A0000X Pediatrics Adolescent Medicine (Licence: MI 4301068721) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-01-18 |