| NPI | 1467986513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61059073) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML) |
| Enumeration Date | 2017-04-16 |
| Last Update Date | 2021-03-30 |