| NPI | 1912067463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 201401824) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101243357) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2015-09-23 |