| NPI | 1760468169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: NV 10664) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 10664) |
| 2080A0000X Pediatrics Adolescent Medicine (Licence: FL ME113575) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2019-09-19 |