NPI | 1710242789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA 156809) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0116024926) |
Enumeration Date | 2012-07-05 |
Last Update Date | 2022-02-21 |