| NPI | 1770709339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2008025570) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301086557) |
| 208000000X Pediatrics (Licence: KS 04-33374) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2011-06-13 |