| NPI | 1104868843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 254619) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D64225) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2014-05-09 |