| NPI | 1942688635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 278154) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03309) |
| 208000000X Pediatrics (Licence: RI LP03309) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2019-10-10 |