| NPI | 1861643397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 64814) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101246331) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2014-07-09 |