| NPI | 1982815171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME138422) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01082384A) |
| 208D00000X General Practice (Licence: VA 0101241220) | |
| Enumeration Date | 2007-05-27 |
| Last Update Date | 2021-05-12 |