| NPI | 1821611427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC LL83159) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2023-01054) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2023-05-16 |