| NPI | 1972185304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101276271) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101276271) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2025-08-11 |