| NPI | 1013999242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 28967) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 43580) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2010-05-21 |