| NPI | 1982227757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A199092) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 289623) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2024-10-28 |