| NPI | 1255482204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60284899) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 49349) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2021-05-26 |