| NPI | 1770848020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 73578) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2012016268) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2015-07-07 |