| NPI | 1619015690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 036501) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VI 1273) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |