| NPI | 1306898903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 23702) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 46311) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2014-01-03 |