| NPI | 1396182440 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: NH 22259) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 60762190) | 
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: WA 60762190) | |
| Enumeration Date | 2013-05-30 | 
| Last Update Date | 2022-01-05 |