| NPI | 1114095627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA a98055) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 35897) |
| 208000000X Pediatrics (Licence: NM MD2006-0500) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2015-07-29 |