| NPI | 1720202922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: CT 026630) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 026630) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2013-12-10 |