| NPI | 1053597799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA MD015856) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00023868) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2008-01-11 |