| NPI | 1912927096 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 41042) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101234705) | 
| Enumeration Date | 2006-07-20 | 
| Last Update Date | 2008-11-04 |