| NPI | 1154402402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: WA MD00045088) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00045088) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2009-02-03 |