| NPI | 1992298731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 88436) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP04334) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2021-06-25 |