| NPI | 1386779122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 44047) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 19504) |
| 208000000X Pediatrics (Licence: MN 50301) | |
| 208000000X Pediatrics (Licence: MP 0483) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2011-07-14 |