| NPI | 1912160813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME110718) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301092607) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2012-07-01 |