| NPI | 1205997590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0059550) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 20434) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2018-07-23 |