| NPI | 1710984075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A67687) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 11072) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2015-09-02 |