| NPI | 1174755896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: DC MD040823) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 27354) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2015-06-03 |