| NPI | 1750129722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 11033958) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11033958) |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-07-16 |