| NPI | 1396092003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q3142) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301100297) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2015-06-10 |