| NPI | 1730183674 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA MD11187R)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 11187)  | 
| Enumeration Date | 2005-06-09 | 
| Last Update Date | 2010-03-03 |