| NPI | 1366650053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N8240) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301083124) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2013-08-09 |