| NPI | 1093819518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 200173) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M7311) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2015-08-11 |