| NPI | 1104080183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60227538) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML60019723) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2015-07-31 |