| NPI | 1073764668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A102013) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301095384) |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2014-01-03 |