| NPI | 1205971223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 49405) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 18011) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2013-03-29 |