| NPI | 1992715395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 60183467) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 31367) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2022-05-19 |