| NPI | 1194864181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60257398) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WY TL1080) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2022-09-15 |