| NPI | 1568704922 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5101021350)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL UO2925)  | 
| Enumeration Date | 2013-03-25 | 
| Last Update Date | 2014-06-23 |