| NPI | 1124012893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI 15886) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 36470) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2021-01-28 |