| NPI | 1871597120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 230231) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 32666) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2011-03-17 |