| NPI | 1619298064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA MD.206847) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 49863) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2014-11-21 |