| NPI | 1336334606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ND 11902) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ND PT11902) |
| 208000000X Pediatrics (Licence: MN 53062) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2021-06-01 |