| NPI | 1982915682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS16937) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0102202885) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2020-10-05 |