| NPI | 1881603512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 58641) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 36348) |
| 208000000X Pediatrics (Licence: WV 22224) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2010-09-14 |