| NPI | 1639134315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 21489) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KY 21489) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2017-01-11 |