| NPI | 1376539601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA 21717) |
| Additional Taxonomies | 2080A0000X Pediatrics Adolescent Medicine (Licence: IA 21717) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2007-09-27 |