| NPI | 1619977097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX J6668) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR E0865) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2007-07-14 |