| NPI | 1790808665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 25050) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE TEP 5475) |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2020-05-05 |