| NPI | 1124207972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX 44844) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 53581) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2015-10-13 |