| NPI | 1154551463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 250865) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT194862) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2013-02-07 |