| NPI | 1891779906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 0431871) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 160504) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2011-06-22 |