| NPI | 1275697542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ACN 253) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 13965) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2018-01-11 |