| NPI | 1124222914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 261540) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101244051) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2015-01-08 |