| NPI | 1962675264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA 4105) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2005018554) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2016-10-12 |