| NPI | 1205037959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101248451) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301086076) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-09-09 |