| NPI | 1255642690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NV 15723) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 61040-20) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2015-10-01 |