| NPI | 1144221292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA MD.10642R) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: LA 10642R) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2016-07-14 |