| NPI | 1801867668 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: NV 14576) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200500963) | 
| Enumeration Date | 2006-01-30 | 
| Last Update Date | 2016-03-23 |