| NPI | 1790779759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101254644) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MN 43075) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: GA 64739) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2014-03-26 |