| NPI | 1073521605 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 32057)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 00026791)  | 
| Enumeration Date | 2006-08-03 | 
| Last Update Date | 2012-02-21 |