| NPI | 1104850650 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX E9337) | 
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: TX E9337) | 
| Enumeration Date | 2006-07-10 | 
| Last Update Date | 2007-11-08 |