| NPI | 1679747935 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX 43986) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01069736A) | 
| Enumeration Date | 2008-04-17 | 
| Last Update Date | 2012-10-17 |