| NPI | 1265602478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 56809) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2006015934) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2014-12-23 |