| NPI | 1053549550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 112450) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 240475) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2015-08-06 |