| NPI | 1871587998 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ AZ10737)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ AZ 10737)  | 
| Enumeration Date | 2005-09-02 | 
| Last Update Date | 2020-11-16 |