| NPI | 1730297045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 43045) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301063626) |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2015-08-13 |