| NPI | 1225032980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 40206) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 44552) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2020-07-23 |