| NPI | 1669600904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD162315) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60385698) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2013-07-01 |