| NPI | 1033406392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 63086) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R72758) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2015-09-21 |