| NPI | 1609814987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 046403) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 216961) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2008-08-04 |