| NPI | 1962851030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 40312) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 142190) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2022-07-21 |