| NPI | 1104053776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OK 5855) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101018070) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2020-03-11 |