| NPI | 1790981009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: RI MD12512) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 229654) |
| Enumeration Date | 2007-06-23 |
| Last Update Date | 2014-01-28 |