| NPI | 1750317558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MT 9533) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 32700) |
| 208000000X Pediatrics (Licence: WI 34991 - 20) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2007-07-08 |