| NPI | 1609988922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NV 15516) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301054643) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-03-10 |