| NPI | 1154535375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MS MS19178) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL DO451) |
| 208000000X Pediatrics (Licence: OH 340070405) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2019-05-21 |