| NPI | 1104141514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0058477) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 60361) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2019-05-06 |