| NPI | 1679521884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NH 9741) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM MD2008-0605) |
| 208000000X Pediatrics (Licence: WI 53672) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2010-03-23 |