| NPI | 1417910977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 36427) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 12937) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2014-08-27 |