| NPI | 1275519712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00044128) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301072950) |
| 208000000X Pediatrics (Licence: MI 4301072950) | |
| 208000000X Pediatrics (Licence: WA MD00044128) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2024-07-23 |