| NPI | 1639105042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2012-02167) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D64341) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2013-02-01 |