| NPI | 1962590117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL 00026345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 00026345) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2018-09-25 |