| NPI | 1306020631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 39178) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC MD39178) |
| 208000000X Pediatrics (Licence: NC 9601337) | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2019-08-13 |