| NPI | 1255399333 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD16709) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD 00030157) | 
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WA MD 00030157) | |
| Enumeration Date | 2006-05-01 | 
| Last Update Date | 2023-06-27 |