| NPI | 1225022734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N4080) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301091594) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2013-12-18 |