| NPI | 1104142611 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: AR E-9707)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.205060)  | 
| 208000000X Pediatrics (Licence: AL MD.33245)  | |
| Enumeration Date | 2010-04-09 | 
| Last Update Date | 2018-05-30 |