| NPI | 1528268851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101255245) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2007-01949) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2019-08-28 |