| NPI | 1114975711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX G8920) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA OP00001494) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-06-16 |