| NPI | 1053339200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 61103) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC TL28040) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2016-01-18 |