| NPI | 1750407607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MO 2000152161) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KS 04-24575) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: OK 15722) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2007-07-09 |