| NPI | 1619936101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: AZ 41509) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A41815) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2012-05-21 |