| NPI | 1225084445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 36065) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SD 4117) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2008-09-04 |