| NPI | 1366677262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME113495) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN13470) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2012-10-01 |