| NPI | 1811067135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 058110) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 026283) |
| 208000000X Pediatrics (Licence: OR 26357) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |