| NPI | 1790871044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD036207) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: DC MD036207) |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2012-02-07 |