NPI | 1225343932 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60170077) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: WA MD60170077) |
Enumeration Date | 2010-08-18 |
Last Update Date | 2019-06-03 |