| NPI | 1093952525 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX J3545) | 
| Additional Taxonomies | 208D00000X General Practice (Licence: TX J3545) | 
| Enumeration Date | 2009-01-21 | 
| Last Update Date | 2009-01-21 |