| NPI | 1891923835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2012013472) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 04-35701) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2012-07-17 |