| NPI | 1972767457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 79388) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.097518) |
| 208000000X Pediatrics (Licence: AZ R70175) | |
| 208000000X Pediatrics (Licence: CA A126120) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2020-03-26 |