| NPI | 1619958584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 33268) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2005 01637) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2011-01-04 |