| NPI | 1710418033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2020-02766) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 83659) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2022-10-11 |