| NPI | 1649558719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 48877) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 18742) |
| Enumeration Date | 2011-07-23 |
| Last Update Date | 2016-11-07 |