| NPI | 1104116904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 13139) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR DO158349) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2015-12-01 |