| NPI | 1124058151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: ME MD12027) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: WI 32087) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2015-03-04 |