| NPI | 1376835496 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD.34423)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101234585)  | 
| 208000000X Pediatrics (Licence: IL 036.127903)  | |
| 208000000X Pediatrics (Licence: OH 35097934)  | |
| Enumeration Date | 2011-05-08 | 
| Last Update Date | 2018-01-22 |