| NPI | 1003814567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-30968) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0430968) |
| 208000000X Pediatrics (Licence: MO 2002014072) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2012-05-31 |