| NPI | 1912963901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-31508) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2005025930) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2016-08-12 |