| NPI | 1497011076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD177014) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD456152) |
| 2080H0002X (Licence: PA MD456152) | |
| 2080H0002X (Licence: OR MD177014) | |
| Enumeration Date | 2012-04-08 |
| Last Update Date | 2016-08-02 |