| NPI | 1790874402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX M4181) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 24836) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2024-02-23 |