| NPI | 1659532158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2010011176) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0435474) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2012-02-03 |