| NPI | 1114059052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA OP00002212) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101015462) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2019-09-18 |