| NPI | 1215268370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD0000014776) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME97322) |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2010-01-28 |