| NPI | 1558482885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2005025976) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0433312) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2011-06-10 |