| NPI | 1912609363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2023019853) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-1164) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-06-19 |