| NPI | 1003881772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 043168) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 246846) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2011-10-05 |