| NPI | 1538422613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: DC MD043285) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0101255656) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2022-10-19 |