| NPI | 1972023810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NM MD2020-0740) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2017020363) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2020-08-27 |