| NPI | 1720641871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 023234) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 023234) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2024-03-16 |