| NPI | 1053639070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 60891239) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A121626) |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2019-12-06 |