| NPI | 1003178971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI 18143) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R73239) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2015-06-09 |