| NPI | 1649538539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 03807) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY R3055) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2015-07-07 |