| NPI | 1407847759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD44834) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 43445) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2020-10-15 |