| NPI | 1902887201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: PA MD028974E) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 043643) |
| 2080A0000X Pediatrics Adolescent Medicine (Licence: CT 043643) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2018-03-17 |