| NPI | 1790979920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX M4930) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G58214) |
| 208000000X Pediatrics (Licence: CO DR0052245) | |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2018-06-16 |