| NPI | 1669601290 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 32900)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 003721)  | 
| Enumeration Date | 2009-07-02 | 
| Last Update Date | 2013-04-12 |