| NPI | 1376834234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KY 46890) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 55687) |
| 208000000X Pediatrics (Licence: KY 46890) | |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: WI 55687) | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2014-09-26 |