| NPI | 1649443920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 107560) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR-50259) |
| 208000000X Pediatrics (Licence: MI 4301103266) | |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2014-06-11 |