| NPI | 1891100954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5101025665) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0102205010) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2020-10-08 |