| NPI | 1669501896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P6200) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101015340) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2016-06-28 |