| NPI | 1912992801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0049622) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME89009) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2024-05-30 |