| NPI | 1740575737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 49682) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 51631) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2024-06-06 |