| NPI | 1245253814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA MD 205223) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C1-0005655) |
| 208000000X Pediatrics (Licence: PA MD-427421) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2012-05-04 |