| NPI | 1356522825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 49371) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 54721) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2015-04-22 |