| NPI | 1053473421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 4074) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SD 1209) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2019-05-03 |