| NPI | 1912975566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD42540) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 15521) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2020-06-26 |