| NPI | 1306057914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 070401) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY ABO 797 603) |
| 208000000X Pediatrics (Licence: MI 4301094423) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2015-07-13 |