| NPI | 1972184349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD226901) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MDRE.ML.61297138) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2025-08-28 |