| NPI | 1760645667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ Pending) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 533339) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2013-07-17 |