| NPI | 1417978107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.093625) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 43664) |
| 208000000X Pediatrics (Licence: LA MD.026395) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2009-07-10 |