| NPI | 1144668005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60748428) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 329707) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2022-10-17 |