| NPI | 1194195412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60901017) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT209858) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2019-08-13 |