| NPI | 1710954839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 20305) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 20305) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2018-04-04 |