| NPI | 1912172214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX M8226) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.201558) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2013-01-09 |