| NPI | 1174563605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX M7569) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 157546) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-01-30 |