| NPI | 1235176264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD00046745) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MT 8402) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2021-12-08 |