| NPI | 1104878164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: TN 37230) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: GA 053565) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2011-05-25 |