| NPI | 1639342512 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D75881) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2007024079) | 
| Enumeration Date | 2008-04-10 | 
| Last Update Date | 2013-10-21 |