| NPI | 1780823336 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q5352)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101017932)  | 
| Enumeration Date | 2009-02-05 | 
| Last Update Date | 2016-02-29 |