| NPI | 1043214778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2015029686) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015029686) |
| 208000000X Pediatrics (Licence: IL 036-100129) | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2017-03-14 |