| NPI | 1720075773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 05-33433) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2003014690) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2012-01-26 |