| NPI | 1376561415 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME79468) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200700845) | 
| Enumeration Date | 2006-07-17 | 
| Last Update Date | 2013-09-16 |