| NPI | 1366603920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD00049261) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00049261) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2016-04-21 |