| NPI | 1194723619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 0423071) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO R9H85) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2012-04-26 |