| NPI | 1235133133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD42627) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 33468) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2020-06-25 |