| NPI | 1962638031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA 4290) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR E-7500) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AR E-7500) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2015-09-29 |