| NPI | 1366762197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 46057) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL32744) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2014-06-03 |