| NPI | 1861582280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 29875) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 060047) |
| 208000000X Pediatrics (Licence: FL ME101312) | |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2012-09-19 |