| NPI | 1629071972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD 39184) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101237513) |
| 207P00000X Emergency Medicine (Licence: TN 39184) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2011-02-22 |