| NPI | 1225398217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 261953) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI MD14926) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2015-06-15 |