| NPI | 1790748994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD44004) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 238606) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2014-03-18 |