| NPI | 1093715997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: PR 8720) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 8720) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2015-12-04 |