| NPI | 1518128396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD039819) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101251162) |
| 208000000X Pediatrics (Licence: MD D0073342) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2012-06-07 |