| NPI | 1568613735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 27988) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 18178) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2016-11-09 |