| NPI | 1043461015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX p0076) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301093295) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2012-10-22 |