| NPI | 1104890045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 36157) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 42259) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2009-05-01 |