| NPI | 1225359953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 256993) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 245115) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2013-12-13 |