| NPI | 1275523144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME146786) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01055880A) |
| 208000000X Pediatrics (Licence: WA MD00048132) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2020-12-22 |