| NPI | 1972869584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 136056) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 25175) |
| 208000000X Pediatrics (Licence: LA MD.208084) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2022-07-21 |