| NPI | 1053489351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD150739) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M5217) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2010-05-04 |