| NPI | 1699967810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ND 12237) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 53118) |
| 208000000X Pediatrics (Licence: WI 54617-20) | |
| Enumeration Date | 2007-08-12 |
| Last Update Date | 2012-09-21 |