| NPI | 1902931058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 053678) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200101531) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2019-10-04 |