| NPI | 1720089022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD08493) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR 8493) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2009-09-25 |