| NPI | 1972865509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 34812) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL 34812) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2015-06-23 |