| NPI | 1952380404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 60118972) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MT 8701) |
| 208000000X Pediatrics (Licence: WY 8328A) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2013-11-18 |