| NPI | 1851787667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX U5722) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME144665) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2024-01-24 |