| NPI | 1043572480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 64068) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA L-251428) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2015-06-30 |