| NPI | 1790783702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: CT 022728) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 22728) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2013-08-02 |