| NPI | 1104177450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60312111) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA AFE114017) |
| 208000000X Pediatrics (Licence: OR MD159692) | |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2012-10-30 |