| NPI | 1083947659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NH 17884) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 242288) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2016-11-01 |