| NPI | 1093007650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0102203801) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT014122) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2014-07-15 |